TY - JOUR
T1 - Outcomes of therapeutic keratoplasty for severe infectious keratitis in Chongqing, a 16-year experience
AU - Zhang, Qi
AU - Zhao, Min
AU - Xu, Mei
AU - Gu, Fengjuan
AU - Liu, Quan
AU - Chen, Yuan
AU - Zhang, Haiqi
AU - Kijlstra, Aize
N1 - Funding Information:
The study was supported by the National Key Clinical Specialties Construction Program of China, the National Key R&D Program of China (2016YFC0904000), the Chongqing Key Laboratory of Ophthalmology (CSTC, 2008CA5003), the National Natural Science Foundation Project (81300754), and the Project of Health Bureau of Chongqing (2016MSXM003). The funding organizations had no role in the design or conduct of this study.
Publisher Copyright:
© 2019 Zhang et al.
PY - 2019
Y1 - 2019
N2 - Purpose: This study aimed to evaluate the outcomes of therapeutic keratoplasty for severe infectious keratitis in Chongqing (Southwest China).Patients and methods: The records of 561 eyes that underwent therapeutic keratoplasty for refractory microbial keratitis from 2001 to 2016 were analyzed in this retrospective study. Data included demographic information, microbiological investigations, associated factors, graft size, preoperative status, postoperative complications, and final anatomical outcomes.Results: Trauma was the most common cause (267, 47.6%) for corneal ulcers leading to therapeutic keratoplasty. The etiological diagnosis included bacterial keratitis (80 eyes, 14.3%), fungal keratitis (317 eyes, 56.5%), acanthamoeba keratitis (3 eyes, 0.5%), and mixed bacteria/fungal infection (15 eyes, 2.7%). Anatomical success was achieved for 492 eyes (87.7%), with bacterial keratitis having a better outcome than fungal and mixed infections. Diabetes and preoperative time >= 30 days were significantly associated with anatomical failure in the multivariate logistic regression (P=0.028 and P=0.022, respectively). Patients with hypopyon, corneal perforation, surgical delay, and/or large graft size had a higher incidence of postoperative complications (reinfection, cataract, glaucoma, hyphema, or graft rejection) (PConclusion: Therapeutic keratoplasty was an effective procedure in managing refractory infectious keratitis. Prompt and appropriate surgery would result in fewer complications and better outcomes.
AB - Purpose: This study aimed to evaluate the outcomes of therapeutic keratoplasty for severe infectious keratitis in Chongqing (Southwest China).Patients and methods: The records of 561 eyes that underwent therapeutic keratoplasty for refractory microbial keratitis from 2001 to 2016 were analyzed in this retrospective study. Data included demographic information, microbiological investigations, associated factors, graft size, preoperative status, postoperative complications, and final anatomical outcomes.Results: Trauma was the most common cause (267, 47.6%) for corneal ulcers leading to therapeutic keratoplasty. The etiological diagnosis included bacterial keratitis (80 eyes, 14.3%), fungal keratitis (317 eyes, 56.5%), acanthamoeba keratitis (3 eyes, 0.5%), and mixed bacteria/fungal infection (15 eyes, 2.7%). Anatomical success was achieved for 492 eyes (87.7%), with bacterial keratitis having a better outcome than fungal and mixed infections. Diabetes and preoperative time >= 30 days were significantly associated with anatomical failure in the multivariate logistic regression (P=0.028 and P=0.022, respectively). Patients with hypopyon, corneal perforation, surgical delay, and/or large graft size had a higher incidence of postoperative complications (reinfection, cataract, glaucoma, hyphema, or graft rejection) (PConclusion: Therapeutic keratoplasty was an effective procedure in managing refractory infectious keratitis. Prompt and appropriate surgery would result in fewer complications and better outcomes.
KW - therapeutic keratoplasty
KW - infectious keratitis
KW - corneal ulcer
KW - MICROBIAL KERATITIS
KW - PENETRATING KERATOPLASTY
KW - FUNGAL KERATITIS
KW - RISK
U2 - 10.2147/IDR.S204025
DO - 10.2147/IDR.S204025
M3 - Article
C2 - 31496763
SN - 1178-6973
VL - 12
SP - 2487
EP - 2493
JO - Infection and Drug Resistance
JF - Infection and Drug Resistance
ER -